NeuroRehabilitation - Volume 41, issue 1

Authors: Lam, Charlene L.M. | Yiend, Jenny | Lee, Tatia M.C.

Article Type: Review Article

Abstract: BACKGROUND: White matter lesions (WML) are prevalent in older adults. The association between WML and cognition in different subtypes of Mild Cognitive Impairment (MCI) is inconsistent in the literature. OBJECTVES: We aim to provide a systematic review on the impact of WML in different subtypes of MCI, and discuss the recent findings on white matter plasticity. METHODS: We reviewed peer-reviewed articles from January 2011 to August 2016 and identified 12 studies investigating the association between WML and subtypes of MCI with both neuroimaging and cognitive measures. RESULTS: Our review shows that 1) WM …abnormality was identified between different subtypes of MCI and healthy controls on diffusion imaging; 2) neither visual ratings of WML nor its volumetry differentiate different subtypes of MCI or its prognosis to dementia; and 3) cognitive correlates of WML were evident in the Amnestic-type MCI in the domains of memory, language, psychomotor speed, attention and executive functions. CONCLUSION: Cognitive reserve and the plasticity of white matter may modulate the impact of WML on the manifestation of the neurodegenerative disease. Further research is needed to study the plasticity of white matter in the MCI population to evaluate its potential clinical application. Show more

Keywords: White matter, Mild Cognitive Impairment, cognitive reserve, neuroplasticity, cognition

DOI: 10.3233/NRE-171471

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 189-204, 2017

Authors: Gougeon, Marie-Anne | Zhou, Lei | Nantel, Julie

Article Type: Research Article

Abstract: BACKGROUND: This study aimed to assess the effect of walking with Nordic Walking (NW) poles on postural stability and gait spatial-temporal characteristics in individuals with PD and to determine the cognitive load associated operating the poles. METHODS: Twelve individuals with PD (age: 61.6±11.7) were asked to perform four 90 s walking trials; with/without poles and with/without verbal fluency task (category fluency) after a 6-week independent NW training. We assessed gait spatial-temporal characteristics, and trunk postural stability using the APDM accelerometry system. RESULTS: Trunk frontal range of motion and peak velocity were smaller in NW compared to …normal walking with and without the cognitive task (p  < 0.01). Cadence, gait speed and stride length decreased in both pole conditions when performed with the cognitive task (p  < 0.05). However stride length was longer with poles compared to without poles. CONCLUSIONS: The reduced range of motion and velocity of the trunk in the frontal plane of motion suggest that NW can improve postural stability independently of the addition of a cognitive task. Compared to normal walking, spatial-temporal characteristics did not further decline when the cognitive task was combined to NW. This suggests that NW is a suitable practice for gait rehabilitation protocols in PD. Show more

Keywords: Nordic Walking, gait, Parkinson disease, trunk stability, postural balance

DOI: 10.3233/NRE-171472

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 205-210, 2017

Authors: Ozinga, Sarah J. | Koop, Mandy Miller | Linder, Susan M. | Machado, Andre G. | Dey, Tanujit | Alberts, Jay L.

Article Type: Research Article

Abstract: BACKGROUND: Postural instability is a hallmark of Parkinson’s disease. Objective metrics to characterize postural stability are necessary for the development of treatment algorithms to aid in the clinical setting. OBJECTIVE: The aim of this project was to validate a mobile device platform and resultant three-dimensional balance metric that characterizes postural stability. METHODS: A mobile Application was developed, in which biomechanical data from inertial sensors within a mobile device were processed to characterize movement of center of mass in the medial-lateral, anterior-posterior and trunk rotation directions. Twenty-seven individuals with Parkinson’s disease and 27 age-matched controls completed …various balance tasks. A postural stability metric quantifying the amplitude (peak-to-peak) of sway acceleration in each movement direction was compared between groups. The peak-to-peak value in each direction for each individual with Parkinson’s disease across all trials was expressed as a normalized value of the control data to identify individuals with severe postural instability, termed Cleveland Clinic-Postural Stability Index. RESULTS: In all conditions, the balance metric for peak-to-peak was significantly greater in Parkinson’s disease compared to controls (p  < 0.01 for all tests). CONCLUSIONS: The balance metric, in conjunction with mobile device sensors, provides a rapid and systematic metric for quantifying postural stability in Parkinson’s disease. Show more

Keywords: Parkinson’s disease, postural stability, mobile device, biomechanics

DOI: 10.3233/NRE-171473

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 211-218, 2017

Authors: Kuo, Yu-Chi | Chan, Jomei | Wu, Yu-Ping | Bernard, Jeffrey R. | Liao, Yi-Hung

Article Type: Research Article

Abstract: PURPOSE: The purpose of this study was to investigate the effects of 4-weeks expiratory muscle strength training (EMST) on the maximum expiratory pressure (PEmax) and quality of life (QoL) in patients with Parkinson disease (PD). METHODS: Thirteen outpatients diagnosed with PD participated in this study, and were assigned into either a 5DE training group (5DE group; n  = 4; 75% PEmax for 5-d/wk), 3DE training group (3DE group; n  = 5; 75% PEmax for 3-d/wk) and control group (3DC group; n  = 4; 0% PEmax for 3-d/wk) by matching their Hoehn and Yahr scale, genders, and age. The PEmax and …Parkinson disease questionnaire-39 item (PDQ-39) were evaluated pre- and post-intervention. RESULTS: The posttest PEmax of the 5DE was significantly higher than that of the 3DC (P  < 0.05). Moreover, 5DE and 3DE but not 3DC significantly increased PEmax after training. There were no differences in the overall quality of life in PD patients measured by PDQ-39 among three groups, but the 5DE group significantly improved the mobility constructs of PDQ-39 compared with 3DC (P  < 0.05). CONCLUSION: Both 5 d/wk and 3 d/wk of EMST effectively enhance respiratory muscle strength and improve mobility construct measured by PDQ-39 in patients with PD. Show more

Keywords: Parkinson disease, maximum expiratory pressures (PEmax), Parkinson disease questionnaire-39 item (PDQ-39)

DOI: 10.3233/NRE-171474

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 219-226, 2017

Authors: Brincks, John | Andersen, Elisabeth Due | Sørensen, Henrik | Dalgas, Ulrik

Article Type: Research Article

Abstract: BACKGROUND: It is relevant to understand the possible influence of impaired postural balance on walking performance in multiple sclerosis (MS) gait rehabilitation. OBJECTIVE: We expected associations between impaired postural balance and complex walking performance in mildly disabled persons with MS, but not in healthy controls. METHODS: Thirteen persons with MS (Expanded Disability Status Scale = 2.5) and 13 healthy controls’ walking performance were measured at fast walking speed, Timed Up & Go and Timed 25 Feet Walking. Postural balance was measured by stabilometry, 95% confidence ellipse sway area and sway velocity. RESULTS: Except from sway …velocity (p  = 0.07), significant differences were found between persons with MS and healthy controls in postural balance and walking. Significant correlations were observed between sway area and Timed Up & Go (r  = 0.67) and fastest safe walking speed (r  = –0.63) in persons with MS but not in healthy controls (r  = 0.52 and r  = 0.24, respectively). No other significant correlations were observed between postural balance and walking performance in neither persons with MS nor healthy controls. CONCLUSION: Findings add to the understanding of postural balance and walking in persons with MS, as impaired postural balance was related to complex walking performance. Exercises addressing impaired postural balance are encouraged in early MS gait rehabilitation. Show more

Keywords: Multiple sclerosis, static postural balance, dynamic postural balance, complex walking

DOI: 10.3233/NRE-171475

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 227-235, 2017

Authors: Felter, Cara E. | Bentley, Jacob A. | Sadowsky, Cristina L. | Wegener, Stephen T.

Article Type: Research Article

Abstract: BACKGROUND: There is a lack of evidence regarding the psychosocial characteristics of individuals with spinal cord injury (SCI) undergoing activity-based restorative therapy (ABRT) treatment. OBJECTIVES: This study seeks to describe the hopefulness of a sample of ABRT participants and describe the relationship between hopefulness and level of rehabilitation engagement. METHODS: A prospective cross-sectional cohort study was conducted using a convenience sample of 73 individuals with SCI (mean time since injury = 66.6 months) seeking out-patient, post-acute rehabilitation at a metropolitan ABRT center. Outcome measures included a demographic survey, The Hope Scale, the Patient Health Questionare-9 and the …Hopkins Rehabilitation Engagement Rating Scale. RESULTS: The ABRT group reported higher levels of hope (M  = 54.78, SD  = 7.13) than have been reported in a sample of individuals with SCI seeking traditional rehabilitation in the acute (M  = 24.58, SD  = 4.06) setting. Rehabilitation engagement was not related to hopefulness in the ABRT group. CONCLUSIONS: The ABRT group demonstrated high levels of hopefulness. The difference in hopefulness noted between this group and previous studies could be due to the time elapsed since injury, the presence of choice in the rehabilitation process, or the possibility that individuals who chose to participate in ABRT may have inherently different hopefulness characteristics than the broader SCI population. Show more

Keywords: Spinal cord injury, hope, rehabilitation, positive psychology

DOI: 10.3233/NRE-171476

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 237-240, 2017

Authors: Drummond, Melanie | Douglas, Jacinta | Olver, John

Article Type: Research Article

Abstract: BACKGROUND: Olfactory impairment (OI) can present in up to 66% of all individuals following traumatic brain injury (TBI) and can have significant implications for everyday life. OBJECTIVE: To investigate the predictive factors, natural progression and consequences of OI following TBI in individuals 12 months post injury. METHODS: In this prospective longitudinal study, 37 adults (28 males, 9 females), mean age 42.3 years (SD 19.4), with predominately severe TBI (mean length of posttraumatic amnesia (PTA) 28.6 days, SD 22.6) were assessed using the University of Pennsylvania Smell Identification Test (UPSIT). Each participant also participated in an …open ended interview to allow exploration of their experience of having OI. RESULTS: Thirty (83.33%) of the participants demonstrated persisting OI at 12 months. Nineteen of these participants demonstrated no change in their OI severity category and 4 produced a poorer performance. Thirteen participants (36.11%) demonstrated some recovery with 6 of these performing within the ‘normal’ range for age andgender. CONCLUSIONS: OI is an enduring impairment for a substantial proportion of individuals who experience it following severe TBI. It impacts a range of everyday activities, regardless of its severity, and requires comprehensive management during rehabilitation. Show more

Keywords: Acquired brain injury, traumatic brain injury, rehabilitation, olfaction, olfactory impairment, smell

DOI: 10.3233/NRE-171477

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 241-248, 2017

Authors: Di Martino, Siria | Unti, Elisa | Tramonti, Caterina | Mazzucchi, Sonia | Bonuccelli, Ubaldo | Rossi, Bruno | Ceravolo, Roberto | Chisari, Carmelo

Article Type: Research Article

Abstract: BACKGROUND: Pisa syndrome (PS) represents an important source of disability in Parkinson’s disease (PD). Currently no consensus has been reached on its definition or diagnostic criteria, and therapeutic approaches are unspecific and often futile. Recently the role of abdominal muscles, and in particular of the external oblique (EO), in the pathogenesis of PS was hypothesized. OBJECTIVES: To evaluate the role of EO and propose a combined therapeutic approach in the management of PS. METHODS: Ten PD patients with PS underwent a combined protocol based on repeated lidocaine injection in EO and rehabilitation program. RESULTS: …Our data confirm the primary role of EO muscles in PS pathogenesis and showed an improvement in truncal flexion and balance with a positive impact on patients’ quality of life after treatment. CONCLUSIONS: These data highlight the need for accurate characterization of PS focusing on the role of abdominal muscles and the need for a specific rehabilitation protocol for PS management. Show more

Keywords: Parkinson’s disease, postural deviation, trunk dystonia

DOI: 10.3233/NRE-171478

Citation: NeuroRehabilitation, vol. 41, no. 1, pp. 249-253, 2017